Biofilm Perio•Aid DENTAID

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  • In the Oral Cavity Numerous microorganisms of different species participate. It starts with a film of salivary proteins on dental enamel  gram + bacilli and cocci (primary colonization) Fusobacterium nucleatum (bridge between primary and late colonizers) P.gingivalis, Aa, T.denticola .
  • Bacteria structured in perfectly organized communities Definition : Biofilm, sessile community characterized by bacteria irreversibly adhered to substrate, to interface and to each other, embedded in a matrix of self-produced extracellular polymeric substances and that show an altered phenotype compared to planktonic bacteria (it is necessary that, aside from the matrix formation and growth on a surface, they show a different phenotype) Community of bacteria  differentiated complex. 99,9% of bacteria grow in the form of a biofilm and are greatly different than planktonic homologues (loose, floating)
  • The basic structural unit is the microcolony. Microcolony15-20% Matrix 85-80% (water, exopolysaccharides, bacterial cells, proteins….) The exopolysaccharides  produced by bacteria themselves. Fundamental components of the biofilm for the great number of functions that they carry out: They can have different charges making interaction with different antimicrobials possible They can trap nutrients from their environment They remove waste from the environment They induce bacterial adhesion The matrix is not solid  offer channels for flow of water, O2, nutrients... to the deepest areas.
  • Diseases in the Oral Cavity Bacterial plaque can be acidic or basic depending on the predominant bacteria. Acidogenic plaque  produce acids (lactic acid) upon metabolizing glucose  Caries Basogenic plaque  production of basic substances  inflammation  PD In dental plaque or biofilm bacteria live together in equilibrium
  • TREATMENT OF THE ORAL BIOFILM There is an enormous difference in susceptibility to antimicrobials between planktonic and sessile bacteria in a biofilm. The bacteria embedded in a biofilm are up to 1,000 times as resistant (the biofilm matrix acts as a diffusion barrier)
  • Antiseptic mouthrinses  Greater spectrum of action than antimicrobials They act upon biofilm removing microorganisms that form it, inhibiting matrix formation and removing bacterial plaque build-up. The most used antiseptics are those that contain: CHX, CPC, Triclosan, hexetidine, Essential oils  in vitro studies in artificial mouths are necessary. In 2002 Shapiro compared bactericidal capacity of CHX, Triclosan, Plant extracts, essential oils, hexetidine vs. destilled water in artificial mouth  CHX highest bactericidal effect BUT not all commercial brands showed the same efficacy (Herrera et al. 2003) In vivo studies  Netuschil: CHX mouthrinses capable of penetrating Biofilm and having great bactericidal effect. Arweiler: that triclosan mouthrinses had little capacity to reduce biofilm vitality and that the activity of CHX mouthrinses depended on their formulation.
  • Antiseptic mouthrinses  Greater spectrum of action than antimicrobials They act upon biofilm removing microorganisms that form it, inhibiting matrix formation and removing bacterial plaque build-up. The most used antiseptics are those that contain: CHX, CPC, Triclosan, hexetidine, Essential oils  in vitro studies in artificial mouths are necessary. In 2002 Shapiro compared bactericidal capacity of CHX, Triclosan, Plant extracts, essential oils, hexetidine vs. destilled water in artificial mouth  CHX highest bactericidal effect BUT not all commercial brands showed the same efficacy (Herrera et al. 2003) In vivo studies  Netuschil: CHX mouthrinses capable of penetrating Biofilm and having great bactericidal effect. Arweiler: that triclosan mouthrinses had little capacity to reduce biofilm vitality and that the activity of CHX mouthrinses depended on their formulation.
  • Both in vitro and in vivo studies show that Combinations of CHX + CPC greater effect (Van Strydonck 2005) Currently more reduced doses of CHX are used (0.05%) along with CPC, which boost their effect, while lowering CHX side effects (Buscher et al. 2008) ADVANTAGES OF COMBINIING CHX+CPC Complex bacterial communities  New galenic demands For control over OB not all CHX are the same Combinations of CHX+CPC obtain better results (Bascones 2006) since they act synergistically. PERIO·AID the only one that controls pathogenic bacterial load (Herrera 2003) The complete composition of a mouthrinse significantly affects its efficacy, no matter which active ingredient is used  this should be taken into account when prescribing it (Herrera 2001)
  • Both in vitro and in vivo studies show that Combinations of CHX + CPC greater effect (Van Strydonck 2005) Currently more reduced doses of CHX are used (0.05%) along with CPC, which boost their effect, while lowering CHX side effects (Buscher et al. 2008) ADVANTAGES OF COMBINIING CHX+CPC Complex bacterial communities  New galenic demands For control over OB not all CHX are the same Combinations of CHX+CPC obtain better results (Bascones 2006) since they act synergistically. PERIO·AID the only one that controls pathogenic bacterial load (Herrera 2003) The complete composition of a mouthrinse significantly affects its efficacy, no matter which active ingredient is used  this should be taken into account when prescribing it (Herrera 2001)
  • Biofilm Perio•Aid DENTAID

    1. 1. ORAL BIOFILM
    2. 2. A Biofilm is a community of microorganisms that adheres to substratum within a self-produced polysaccharide matrix and that show an altered phenotype compared to planktonic bacteria. ORAL BIOFILM
    3. 3. Microcolony 15-20% + Matrix 85-80% (water, bacterial cells, proteins, exopolysaccharides , ….) Essential for their functions
    4. 4. The complexity of the bacteria  SURVIVAL STRATEGY
    5. 5. BIOFILM  CONSEQUENCES? BIOFILM PATHOGENICITY
    6. 6. BIOFILM AND PERIODONTAL DISEASE Polycaries
    7. 7. BIOFILM MONOGRAPH
    8. 8. New requirements in the therapeutic control of PD The bacteria embedded in a biofilm are up to 1,000 times as resistant TREATMENT OF ORAL BIOFILM
    9. 9. ANTISEPTIC MOUTHRINSES ( affect the biofilm ) CHX CPC Triclosan Essential oils Hexetidine IN VITRO TEST (Artificial Mouth) IN VIVO STUDIES TREATMENT OF ORAL BIOFILM
    10. 10. <ul><li>In vitro studies (artificial mouth)  </li></ul><ul><ul><li>CHLORHEXIDINE (CHX) greater bactericidal effect * but NOT all commercial brands showed the same efficacy ( Herrera et al. 2003) </li></ul></ul><ul><li>In vivo studies  </li></ul><ul><ul><li>CHX mouthrinses able to penetrate the Biofilm and exert a greater bactericidal effect**. </li></ul></ul><ul><ul><li>Mouthrinses with triclosan have little capacity to reduce the vitality of a biofilm (Arweiler) </li></ul></ul><ul><ul><li>The effect of the CHLORHEXIDINE mouthrinses depended on their formulation . (Arweiler) </li></ul></ul><ul><li>*In 2002 Shapiro compared the bactericidal capacity of CHX, Triclosan, Plant extracts, essential oils and hexetidine vs. destilled water in an artificial mouth **Netuschil </li></ul>
    11. 11. <ul><li>Both in vitro and in vivo studies prove that combinations of CHX+CPC greater effect (Van Strydonck 2005) </li></ul><ul><li>Currently, lower levels of CHX (0.05%) are being used together with CPC, which improves its effect while reducing CHX’s side effects (Buscher &cols 2008) </li></ul>Advantages of combining Chlorhexidine + Cetylpiridinium Chloride
    12. 12. ADVANTAGES against planktonic bacteria CHX ANTISEPTIC MOUTHRINSES There are MORE AND MORE DIFFERENCES between CHX all the time TREATMENT OF ORAL BIOFILM
    13. 13. Superior control over oral biofilm, for a better handle on gum disease .
    14. 14. THE ONLY ONE THAT ACHIEVES MAXIMUM CONTROL OVER ORAL MICROBIAL LOAD
    15. 15. <ul><li>www.dentaid.com </li></ul>http://www.blogsaludbucal.es/ http://twitter.com/dentaid

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